Aortic Valve Problems and Treatment

Who is more likely to have aortic valve problems?

Aortic valve problems is generally seen in older ages. There are two types of diseases of the aortic valve. The first is the leakage of the valve, which we call aortic regurgitation, towards the tube. Another is aortic stenosis.

In which cases are these closed treatments preferred instead of open surgery in aortic valve problems?

In the 1950s, the narrow valve was cut with open heart surgery and a new valve was placed in its place. Later, surgeries started to be done with small incisions. The patient's heart was stopped, the valve was removed, and a surgery was performed in the style of inserting a new valve. Nowadays, closed system is easily applied, especially in patients who are at risk for surgery, such as the elderly.What is non-surgical aortic valve replacement TAVI?TAVI is a procedure performed by entering the inguinal or arm vein, sometimes through the jugular vein, without opening the thorax. In short, it is the placement of a new valve into the narrow aortic valve by entering through a vein without the need for open heart surgery.Non-Surgical Heart Valve Replacement (TAVI) IN AORTIC VALVE PROBLEMS

Who is the appropriate patient group for Non-Surgical Heart Valve Replacement (TAVI)?

TAVI should be applied primarily to all patients over a certain age who will be fitted with a biological valve, and surgery should be applied to patients who cannot undergo TAVI. In particular, all patients over the age of 60-65 should primarily prefer a biological valve. In these patients, open surgery should be considered if there is a situation where TAVI cannot be performed technically or anatomically.

What kind of anesthesia is used in Non-surgical Heart Valve Replacement (TAVI)? How long does the application take?

TAVI has been applied around the world for 10 years. General anesthesia was used in the first years. Afterwards, it was started to be performed with local anesthesia and mild sedation. The process takes an hour on average if all goes well. The length of stay in the hospital is shaped by the situation of each individual. If the general health of the patient is inconvenient, the patient can be kept in the intensive care unit for a few days. However, if everything goes well, they are kept for observation only for one day in the intensive care unit, one day in the service and discharged the next day.

When can the patient return to their social or business life after the procedure?

The patient can easily return to their social life after discharge. Because there is no general anesthesia and the rib cage is not opened. Since TAVI is performed with local anesthesia, the patient can go to the normal service the next day and walk around the service. After discharge, they can easily return to normal life.
What should be considered especially in terms of drug use after the operation?
These are biological valves; that is, they are valves obtained from a bovine or pig pericardium. Therefore, they are compatible with the body. For this, drugs that dilute the blood seriously are not needed. But mild blood thinners are used for a while. It is taken as doubles for about 6 months. After 6 months, a drug such as baby aspirin is used for life.

What are the advantages of this method?

The most important advantage is that the patient's chest is not opened and the heart is not stopped. In addition, the patient does not receive general anesthesia. When we look at the complications of surgery, especially when compared to surgery, kidney failure is less in these studies. Some rhythm disorders are also less in this process. Procedure time is shorter. Also, the length of stay in the intensive care unit is shorter. The patient easily returns to normal life. The durability of the biological valve is also an important advantage. Studies of about 7-8 years were observed. According to these studies, there is no doubt that it is durable. However, it will be possible to say more when the studies that have been going on over 10 years get completed. In addition, a new valve can be inserted into this valve with a similar procedure.